A Conundrum: Preserving Fertility When It Is Threatened By Life-Saving Medicine

Angela Thomas thought her breast cancer diagnosis and the double mastectomy that followed were the most traumatic things she would ever experience.

Then, when the 32-year-old actress sought fertility treatment so she could have a baby after the cancer care was finished, her insurance company refused to pay.

"Trying to figure out … how I am going to finance this has been more stressful and more difficult than the actual surgery," said Thomas, who is being treated at the University of Southern California’s Keck Hospital. "It is really daunting and extremely upsetting."

Thomas didn't need chemotherapy, which can affect fertility. But her doctors told her she shouldn’t get pregnant for the next five years, while she was on a cancer-related medication, and that having a healthy baby could be harder in her late 30s.

About 70,000 people between the ages of 15 and 39 are newly diagnosed with cancer each year, and many risk infertility as a result of chemotherapy, radiation and other treatments. There are a growing number of options to preserve fertility, but they can cost tens of thousands of dollars and are usually not covered by health plans.

"It is not cheap for anybody, but for a young adult this is really tough," said Pam Simon, a nurse practitioner and program manager at the Stanford Adolescent and Young Adult Cancer Program. "They have just started their career and cancer has thrown a big wrench into that. Not having this covered is a big deal."

California state Sen. Anthony Portantino (D-La Cañada Flintridge) proposed legislation this month that would require insurers beginning in 2018 to cover fertility preservation services when necessary medical treatments may cause infertility. Covering this type of care is the "right thing to do" for young patients, many of whom are facing life-threatening diagnoses, Portantino said.

"You should think about getting healthy," said Portantino. "You shouldn't have to worry about losing your fertility."